Decompression of lateral femoral cutaneous nerve in treatment of meralgia paraesthetica caused by pelvic fracture
10.3760/cma.j.cn441206-20230524-00091
- VernacularTitle:股外侧皮神经松解术治疗骨盆骨折引起的感觉异常性股痛
- Author:
Jixin WU
1
;
Jiayu SUN
;
Bin CHU
;
Shaonan HU
;
Liang CHEN
Author Information
1. 复旦大学附属华山医院手外科，上海 200032
- Keywords:
Lateral femoral cutaneous nerve;
Pelvic fracture;
Meralgia paraesthetica;
Decompression
- From:
Chinese Journal of Microsurgery
2024;47(1):48-52
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy in decompression of lateral femoral cutaneous nerve (LFCN) through a small incision, following precise localisation with auxiliary examinations, in the treatment of meralgia paraesthetica (MP) caused by pelvic fractures.Methods:A retrospective study was conducted on 6 patients with MP caused by pelvic fractures at the Department of Hand Surgery, Huashan Hospital, Fudan University between June 2019 and June 2022. Among the 6 patients with MP caused by pelvic fractures, 4 were treated conservatively, 1 received an internal fixation with a steel plate, and the other received an internal fixation with screws. The average time after the injury to surgery was 5.33 (range: 3-7) months. Preoperative ultrasound and CT scans were performed to identify the sites of compression on LFCN. After the decompression of LFCN, Visual analog scale (VAS) scores were employed to compare the therapeutic effectiveness with what that before surgery, at 3 months and within 1 year (7-11 months) after surgery. SPSS 26.0 data statistical was used analysis software for data analysis and processing, the data was represented as (Mean ± SD). Friedman test was used to compare the differences in VAS scores among 6 patients before surgery, at first postoperative follow-up, and second postoperative follow-up. If the differences were statistically significant, pairwise comparisons were further conducted, and the Bonferroni correction method was used to adjust the significance level. P<0.05 indicated a statistically significant difference. Results:After the LFCN decompression, all patients showed a decrease in VAS scores with significantly reduced area of skin paraesthesia at the first postoperative follow-up review. At the second review, all patients scored VAS zero, except 1 who was scored 2. There was a statistically significant difference compared to preoperative VAS scores (Friedman test: χ2=12.0, P=0.002; paired t-test: P=0.002). Conclusion:For the meralgia paraesthetica caused by pelvic fractures, compression points on LFCN can be easily identified through auxiliary examinations. Precise release of the LFCN from compression through a small incision, after an accurate localisation, provides a rapid and complete relief of pain and sensory abnormalities.
